Physician and family factors which influence the consent process in pediatric organ donation.

摘要

In order to achieve the vast health potential associated with an increased supply of organ donations, this study was conducted to identify physician and family factors which may influence the consent process in pediatric organ donation. Two hundred and thirty-one faculty and resident physicians in pediatrics, family practice, and emergency medicine completed a Physician Questionnaire on Organ Donation, a Death Depression Questionnaire, and a series of case vignettes involving physician/family interaction at the time of child brain death.;Results indicated that physicians' attitude toward death, their beliefs about organ donation, their past experience of counseling families regarding organ donation, their personal donorship status, and their sense of how the consent process impact the family's grieving process affected their individual judgments on how favorably families would respond to the consent process. The family's acceptance of their child's death and physician/family rapport were powerful factors in determining physicians' ease in approaching families, their perception of the overall benefit of organ donation on family grief, and how favorably families would consent to donation. The degree of parents' medical sophistication and altruistic tendencies were also significant factors in determining the physician's level of ease, impact on family grief, and family likelihood of donation but contributed less to the explained variance.;These findings suggest that efforts to increase organ donation may be enhanced by psychoeducational methods which decrease physician discomfort with death and dying issues, enhanced physicians' awareness of the positive impact of organ donation on contributing families, and increase the number of physicians who have donor cards.;Additional studies are needed to determine if the attitudes displayed in this case vignette design have a direct impact on actual physician behavior when facing child brain death. Training and educational interventions could then be tested to determine their effectiveness in changing attitudes and improving physician skill in handling this very sensitive and demanding task.